In prosthetic fixation such as hip replacements a part of an existing bone is removed, providing a fixating surface, for example by drilling and/or reaming a hole in the remaining bone. A prosthesis is then fixed to said surface, providing for a stable configuration and replacement of a joint.
For fixating said prosthesis to said surface various means and techniques are known and commonly used. At present these techniques can roughly be divided into cemented and non-cemented prosthesis. Cemented prosthesis are fixated to a fixating surface using a layer of bone cement, for example a cement based on polymethyl metacrylate. The cement adheres both to the prosthesis and to the fixating surface. In non-cemented techniques various means can be used, such as clamping means, screws and the like, which mechanically fixate the prosthesis to and/or through the bone. A different approach is to allow bone and other tissue to grow onto and/or into a prosthesis. To this end a part of the prosthesis can be provided with a bone growth stimulating and bone adhering coating. Initially after fixation a person or animal having received the prosthesis will be allowed to load the joint only to a limited extend.
It is also known to use bone chips which are provided as a layer between the fixating surface and a part of the prosthesis, after which bone and other tissue is allowed to grow into said layer of bone chips. Such method is for example described in U.S. Pat. No. 5,047,035. In this known technique, which is normally in hip prosthesis replacement surgery, a layer of bone chips harvested from the patient or from a donor bank is provided in a bore in a femur, after which a compacting device is inserted in said bore, which is used for compacting said layer against the wall of said bore. Then a layer of cement is provided inside an opening in said layer which results from removing said device after compacting. A stem of a prosthesis is then positioned within said layer of bone cement, fixating said prosthesis.
A problem in revision surgery as described above is bone stock loss. Bone stock restoration is one of the key factors in long-term stability of implants such as prosthesis, especially in revision surgery. To this end bone impaction grafting (BIG), using bone chips which are impacted in to bone defects, as disclosed above, has proven promising because it restores the original bone stock. For BIG only human allograft and some autograft bone chips are used. Xenografts may be considered but currently are used on a very small scale for different reasons. One of the problems of this technique is a shortage of allograft bone chips as a result of the strongly increased and still increasing number of arthroplasties. Moreover, the application of allografts and xenografts has the potential hazard of disease transmission and rejection by the recipient. Furthermore, religious or other convictions can be a potential obstacle for the application thereof.
From WO 00/13615 it is known to use a pouch filled with a batch of a mixture of porous granules of tissue compatible material and disintegrated tissue-compatible biological material such as bone meal, to which mixture a further tissue-compatible component has been added which allows modelling or moulding of the mixture within the pouch. The pouch is vibrated in order to obtain sufficient compacting of the mixture before use. In vivo bone and other tissue is allowed to grow into said pouch and into said mixture, for obtaining a desired fixation. Loading of the prosthesis directly after placement should be avoided. Use of the pouches is difficult, especially during placement in relatively narrow, deep holes such as for fixating a femoral component. Moreover, still allograft, autograft and/or xenograft bone chips have to be made available.
A goal of the present invention is to provide an alternative means and technique for fixating a prosthesis or part thereof and/or filling osseous defects.
A further goal of the present invention is to overcome at least one of the drawbacks of at least one of the techniques described here above.
A further goal of the present invention is to provide a kit of parts, suitable for prosthesis fixation, especially but not exclusively in revision surgery.
A still further goal of the present invention is to provide for a method for fixating a prosthesis or part thereof and/or filling osseous defects.